It’s useful to recall that the health care crisis was big, complex and stubborn even before the Affordable Care Act, also known as Obamacare.
So the blame games now being played by partisans really don’t resonate with most Americans.
Republicans blame former President Barack Obama and Democrats for regulations that mandate such things as digital medical records, which they argue push up costs.
Democrats blame Republicans for sabotaging the ACA, resulting in higher costs and less access.
The ACA was approved a decade ago and phased in over several years.
Before it became law, millions of Americans were financially ruined by medical bills. Those with diabetes, heart conditions, a history of cancer or hundreds of other medical issues could not buy insurance at any price. The ACA, among its many provisions, required insurance companies to provide coverage to those with pre-existing conditions.
That was one of the popular parts of the ACA. The marketplace, with its subsidies for many people buying insurance, was another. As a result of the ACA, the percentage of Americans without health insurance dropped from more than 16 percent to about 10 percent in 2018.
To pay the costs of the ACA — yes, it was designed to pay for itself — taxes were raised.
The higher taxes and costs led to big adjustments from insurance companies and U.S. employers, on whom the ACA placed the most demands. To protect their profits, insurance companies and employers started shifting more costs to workers.
For example, deductibles have tripled in the last decade, according to reporting by the Los Angeles Times. Even more troubling, those hit with higher deductibles are workers who make less than $100,000 a year.
Those deductibles are on top of monthly premiums that run from a couple of hundred dollars for a young, single adult to $1,000 or more for older self-employed Americans. The costs of both premiums and deductibles are rising much faster than wages.
Many families and self-employed workers have to spend $15,000 or $20,000 a year in premiums and deductibles before their insurance pays for anything.
As a result, more Americans have insurance, but fewer of them can afford to use it.
Four in 10 U.S. workers said they had trouble affording health care in the past year, according to a survey conducted as part of the research done by the Los Angeles Times and the Kaiser Family Foundation.
As Kansas and federal officials pick apart the ACA and allow insurance companies to flout its provisions, the problem is growing bigger. Providing less coverage and higher deductibles is not giving consumers more choice. It’s giving insurance companies ways to maximize profits.
No doubt, the ACA needed adjustments. But the changes over the past couple of years have not improved affordability or access.
Currently, many Democrats are calling for huge expansions of publicly funded health care far beyond the controversial ACA. Republicans counter with vows to repeal the ACA. They also promise something even better, which they will reveal only if we re-elect them.
It makes little sense to push for an expansive, expensive system when Americans’ support of the ACA has been uncertain and easily undermined. It makes even less sense to sign on to a plan that doesn’t exist.
If the goal is to help Americans ensure their health and financial security, lawmakers should work to make incremental improvements to Obamacare, striving to keep costs reasonable and access guaranteed.
A native of Garden City, Julie Doll is a former journalist who has worked at newspapers across Kansas.